Shin Splints

Whether you're running after a soccer ball, jogging around the neighborhood park or training for a marathon, you're at risk of running-related injuries. One of the most common running injuries is shin splints.

People sometimes mistakenly use the term shin splints to refer to a wider array of lower leg problems. The term technically refers to a specific problem that causes pain along your shinbone (tibia) — the large bone in the front of your lower leg. The pain is the result of an overload on your tibia and the connective tissues that attach your muscles to your tibia. The medical term for this condition is medial tibial stress syndrome.

Shin splints are common among runners. But shin splints can also be caused by other activities that involve repeated impact on your feet on hard surfaces, including basketball, aerobic dancing and tennis.

Most of the time, you can treat shin splints with self-care steps and rest. And you can help prevent shin splints from recurring by stretching, using shoe inserts and modifying your exercise routine. The risk of shin splints is no reason to give up your morning jog or afternoon aerobics class.

Signs and symptoms

Shin pain
image 1 - Pain on the inside of the lower third of the shin.
Shin splints

If you have shin splints, you may notice:

bulletTenderness, soreness or pain along the inner part of your lower leg
bulletMild swelling

At first, the pain may stop when you stop running or exercising. Over time, though, you may feel continuous pain in the affected shins.

Causes

Pain along the inside of the shin or tibial bone is commonly the result of overdoing athletic activities, engaging in sports with a lot of starts and stops, or running down hills. Shin splints may also be the result of:

bulletTraining mistakes, such as the "terrible toos" — training too hard, too fast or for too long
bulletRunning on a slanted or tilted surface
bulletRunning in worn-out footwear

If you have flat arches, your feet may have a tendency to roll too far inward (overpronate) when running, which can contribute to shin splints.

When to seek medical advice

Most of the time, you can take care of shin pain on your own. See your doctor if pain persists, even after self-care steps, or if you believe recovery is too slow.

Seek medical care right away if:

bulletPain in your shin follows a fall or accident and is severe
bulletYour shin is hot and inflamed
bulletYou have persistent pain in your shin at rest or at night
bulletSwelling in your shin seems to be getting worse

Screening and diagnosis

Your doctor will likely diagnose shin splints based on a physical exam and a discussion about your athletic activities. In some cases, your doctor may order an X-ray to rule out other conditions, such as a stress fracture.

It's easy to mistake shin splints for a stress fracture — another common sports injury that results in a tiny crack in your bone because of overuse. A stress fracture in the lower leg usually causes a more localized pain in the middle of the tibia, directly over the bone. It may not show up on an X-ray until two or three weeks after symptoms of pain and swelling appear.

Treatment

In most cases, you can treat shin splints with self-care steps. If you have recurrent injuries that seem to be caused by flatfeet or other problems with the mechanics of your feet, your doctor may prescribe custom-made arch supports (orthotic devices). You place these devices inside your athletic shoes like foot pads. They help prevent your arches from collapsing and the force from the ground from concentrating in your shins.

Prevention

Take these steps to help prevent injury to your shins:

bulletWear proper footwear. Choose a shoe that suits your sport — and your foot. If you're a runner, buy new shoes about every 400 miles.
bulletConsider shoe inserts. If you have flatfeet, you may benefit from wearing an arch support to help cushion and disperse the impact on your legs.
bulletLessen the impact. Cross-train with a sport that places less impact on your shins, such as swimming, walking or riding a bicycle.
bulletStart smart. If you're starting a new athletic activity, start slowly and add time and intensity gradually. If you're a new runner, start with a pace that meets the "talk test" — if you can't carry on a conversation with your running buddy, you're moving too fast.
bulletAdd strengthening and stability training to your workout. Stronger muscles can better withstand the impact of athletic activities, and stability training may help minimize forces being transmitted up your lower leg. Strengthen your lower leg muscles with calf raises and leg presses. Strengthen your ankles with exercises using a resistance band or tube. For stability training, try one-leg standing. Place your feet at shoulder width and extend your arms straight in front of you. Then lift one of your legs and bend it back. Hold for about five seconds and repeat several times, and then switch legs.

Self-care

If you have shin splints, try the R.I.C.E. method for self-care — rest, ice, compression, elevation.

bulletRest. Avoid activities that cause pain, swelling or discomfort. But don't avoid all physical activity. Instead, give yourself relative rest. That means reducing the duration and frequency of your high-impact athletic activities. Just how far you cut back depends on the severity of your pain. For a while, you may need to switch to low-impact exercises, such as swimming, bicycling or water running. If your shin pain is severe and causes you to limp, you may need to use crutches until you can walk normally without pain. When you resume your activities, ease back into them. If you don't, your symptoms may return.
bulletIce. For at least several days after injury and as long as there is any swelling, apply an ice pack to the painful area for 15 minutes several times a day. Cold reduces pain, swelling and inflammation in injured muscles, joints and connective tissues.
bulletCompression. Compress the area with an elastic bandage or compression sleeve to help control swelling and improve symptoms. A compression sleeve is especially helpful if sore muscles are the main cause of your pain. If you use an elastic bandage, don't wrap it too tightly or you may hinder circulation. Begin wrapping at the end farthest from your heart. Loosen the wrap if the pain increases, the area becomes numb or swelling is occurring below the wrapped area.
bulletElevation. To reduce swelling, elevate the injured area above the level of your heart, especially at night. Gravity helps reduce swelling by draining excess fluid.

For pain relief, try an over-the-counter medication such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others).